Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis

Rationale: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. Objectives: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function i...

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Main Authors: Ramsey, K., Ranganathan, S., Park, J., Skoric, B., Adams, A., Simpson, S., Robins-Browne, R., Franklin, P., De Klerk, N., Sly, P., Stick, S., Hall, Graham
Format: Journal Article
Published: American Thoracic Society 2014
Online Access:http://hdl.handle.net/20.500.11937/54721
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author Ramsey, K.
Ranganathan, S.
Park, J.
Skoric, B.
Adams, A.
Simpson, S.
Robins-Browne, R.
Franklin, P.
De Klerk, N.
Sly, P.
Stick, S.
Hall, Graham
author_facet Ramsey, K.
Ranganathan, S.
Park, J.
Skoric, B.
Adams, A.
Simpson, S.
Robins-Browne, R.
Franklin, P.
De Klerk, N.
Sly, P.
Stick, S.
Hall, Graham
author_sort Ramsey, K.
building Curtin Institutional Repository
collection Online Access
description Rationale: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. Objectives: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function in childhood. Methods: Lung function (forced expiratory volume in the first three-quarters of a second [FEV0.75], FVC) was assessed in individuals with cystic fibrosis diagnosed after newborn screening and healthy subjects during infancy (0–2 yr) and again at early school age (4–8 yr). Individuals with cystic fibrosis underwent annual bronchoalveolar lavage fluid examination, and chest computed tomography. We examined which clinical outcomes (pulmonary inflammation, infection, structural lung disease, respiratory hospitalizations, antibiotic prophylaxis) measured in the first 2 years of life were associated with reduced lung function in infants and young children with cystic fibrosis, using a mixed effects model. Measurements and Main Results: Children with cystic fibrosis (n = 56) had 8.3% (95% confidence interval [CI], –15.9 to –6.6; P = 0.04) lower FEV0.75 compared with healthy subjects (n = 18). Detection of proinflammatory bacterial pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Aspergillus species, Streptococcus pneumoniae) in bronchoalveolar lavage fluid was associated with clinically significant reductions in FEV0.75 (ranging between 11.3 and 15.6%). Conclusions: The onset of lung disease in infancy, specifically the occurrence of lower respiratory tract infection, is associated with low lung function in young children with cystic fibrosis. Deficits in lung function measured in infancy persist into childhood, emphasizing the need for targeted therapeutic interventions in infancy to maximize functional outcomes later in life.
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publishDate 2014
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spelling curtin-20.500.11937-547212017-09-29T06:32:57Z Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis Ramsey, K. Ranganathan, S. Park, J. Skoric, B. Adams, A. Simpson, S. Robins-Browne, R. Franklin, P. De Klerk, N. Sly, P. Stick, S. Hall, Graham Rationale: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. Objectives: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function in childhood. Methods: Lung function (forced expiratory volume in the first three-quarters of a second [FEV0.75], FVC) was assessed in individuals with cystic fibrosis diagnosed after newborn screening and healthy subjects during infancy (0–2 yr) and again at early school age (4–8 yr). Individuals with cystic fibrosis underwent annual bronchoalveolar lavage fluid examination, and chest computed tomography. We examined which clinical outcomes (pulmonary inflammation, infection, structural lung disease, respiratory hospitalizations, antibiotic prophylaxis) measured in the first 2 years of life were associated with reduced lung function in infants and young children with cystic fibrosis, using a mixed effects model. Measurements and Main Results: Children with cystic fibrosis (n = 56) had 8.3% (95% confidence interval [CI], –15.9 to –6.6; P = 0.04) lower FEV0.75 compared with healthy subjects (n = 18). Detection of proinflammatory bacterial pathogens (Pseudomonas aeruginosa, Staphylococcus aureus, Haemophilus influenzae, Aspergillus species, Streptococcus pneumoniae) in bronchoalveolar lavage fluid was associated with clinically significant reductions in FEV0.75 (ranging between 11.3 and 15.6%). Conclusions: The onset of lung disease in infancy, specifically the occurrence of lower respiratory tract infection, is associated with low lung function in young children with cystic fibrosis. Deficits in lung function measured in infancy persist into childhood, emphasizing the need for targeted therapeutic interventions in infancy to maximize functional outcomes later in life. 2014 Journal Article http://hdl.handle.net/20.500.11937/54721 10.1164/rccm.201407-1277OC American Thoracic Society restricted
spellingShingle Ramsey, K.
Ranganathan, S.
Park, J.
Skoric, B.
Adams, A.
Simpson, S.
Robins-Browne, R.
Franklin, P.
De Klerk, N.
Sly, P.
Stick, S.
Hall, Graham
Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title_full Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title_fullStr Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title_full_unstemmed Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title_short Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
title_sort early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
url http://hdl.handle.net/20.500.11937/54721